Southeastern Surgery
Clinic/Center · Logan, OH
Practice location
144 East Main StreetLogan, OH 43138
- Phone
- (740) 385-1881
- Fax
- (740) 385-1875
NPI record
- NPI
- 1639536089
- Entity type
- Organization (Type 2)
- Enumeration date
- January 15, 2016
- Last updated
- January 15, 2016
- Organization subpart
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X |
34. 002686 | OH |
Mailing address
12413 State Route 93 NLogan, OH 43138-9306
- Phone
- (740) 385-3318
- Fax
- (740) 385-1875
Authorized official
- Name
- Dr. John Duffy Dewalt, DO
- Title
- Surgeon
- Phone
- (740) 385-1881
About Southeastern Surgery
Southeastern Surgery is a healthcare organization registered in the NPI registry with the primary taxonomy Clinic/Center (code 261Q00000X). The practice location is 144 East Main Street, Logan, OH 43138. The NPI number 1639536089 was assigned on January 15, 2016 and the record was last updated on January 15, 2016.
Southeastern Surgery lists a license in the registry: #34. 002686 (OH) for Clinic/Center. License numbers are self-reported to NPPES; verify them with the state licensing board.
The authorized official for this organization is Dr. John Duffy Dewalt, DO, Surgeon.
Frequently asked questions
What is the NPI number of Southeastern Surgery?
The NPI number is 1639536089.
What is the phone number of Southeastern Surgery?
The phone number listed for the practice location is (740) 385-1881.
Where is Southeastern Surgery located?
144 East Main Street, Logan, OH 43138.
What is the taxonomy code for Southeastern Surgery?
The primary taxonomy code is 261Q00000X – Clinic/Center.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.